Laser Use in Physical Therapy & Fitness
by Dr. Diane Hartley, PT, DPT, RCMT
Laser: Light Amplification by Stimulated Emission of Radiation
Laser is a focused beam of light. All the photons are traveling in the same direction and at the same wavelength. It is a coherent light. The physiological effects are more profound than any other modality that we use in physical therapy.
The hot laser is what is used for surgical procedures and to cauterize tissue. There is a thermal effect and the wattage output is above 1 watt. In physical therapy, we use the cold laser or the low level laser. There is no thermal effect and the output is below 1 watt.
There are over 200 studies documenting the effects of the low level laser. They show that the laser can increase the action potential of nerves. DNA is stimulated. There is a local effect on the immune system with increasing levels of lymphocyte activity. There is an increase in the formation of capillaries with increased release of growth factors. Increase in macrophage and leukocyte production and activity has been documented.
It has also been documented that the laser increases ATP at the cellular level. The significant increase in ATP at myosin has a profound effect on the modulation of muscle. There is a change in the cell membrane permeability to calcium uptake also affecting the contractility of muscle. The low level laser stimulates the mitochondria and the cellular enzymes. There is increased microphage activity and collagen synthesis. A significant increase in granulation tissue occurs. There is an increase in the permeability of cell membranes. Increased serotonin and endorphins with decreased C fiber have been documented. There is improved cell proliferation.
The results of the use of the laser are decreased pain and increased healing capabilities. It can be used to normalize muscle activity to "re-set" the muscle and muscle reeducation. The rate of nerve regeneration is significantly increased. Range of motion can be increased.
The Erchonia Laser that is used at Hartley Physical Therapy & Fitness received the ADA marketing approval January 17, 2002. It was the first to earn the market clearance for a broad number of acute and chronic conditions. The Erchonia Laser produces a red 635nm of line generated laser beam.
The Erchonia Laser can be used to treat a wide variety of conditions including acute and chronic pain, inflammatory conditions, migraines, restricted ROM of joints, muscle spasms, wound healing, carpal tunnel, plantar fascitis, pelvic and rectal pain, balance disorders any many more conditions. Different tissues respond to different frequencies of light. The Erchonia Laser can be programmed to deliver 4 different frequencies at the same time.
The results that we are getting with our patients are phenomenal. It is not the perfect modality for everyone. The patient will still require manual techniques and exercise. The low level laser is the most exciting development in the field of physical therapy that has happened in the last 30 years.
